Provider Demographics
NPI:1922597889
Name:ERIN K ELKINS
Entity Type:Organization
Organization Name:ERIN K ELKINS
Other - Org Name:WATERSHED BIRTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-779-2077
Mailing Address - Street 1:1510 W YAKIMA AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2951
Mailing Address - Country:US
Mailing Address - Phone:509-367-7158
Mailing Address - Fax:
Practice Address - Street 1:1510 W YAKIMA AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2951
Practice Address - Country:US
Practice Address - Phone:509-367-7158
Practice Address - Fax:509-453-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2155125Medicaid